BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 584|
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UNFINISHED BUSINESS
Bill No: SB 584
Author: Chesbro (D), et al
Amended: 9/3/99
Vote: 27 - Urgency
SENATE HEALTH & HUMAN SERV. COMMITTEE : 6-0, 4/7/99
AYES: Escutia, Figueroa, Hughes, Mountjoy, Solis,
Vasconcellos
NOT VOTING: Haynes, Morrow, Polanco
SENATE APPROPRIATIONS COMMITTEE : 13-0, 5/27/99
AYES: Johnston, Alpert, Bowen, Burton, Escutia, Johnson,
Karnette, Kelley, Leslie, McPherson, Mountjoy, Perata,
Vasconcellos
SENATE FLOOR : 40-0, 6/3/99
AYES: Alarcon, Alpert, Baca, Bowen, Brulte, Burton,
Chesbro, Costa, Dunn, Escutia, Figueroa, Hayden, Haynes,
Hughes, Johannessen, Johnson, Johnston, Karnette, Kelley,
Knight, Leslie, Lewis, McPherson, Monteith, Morrow,
Mountjoy, Murray, O'Connell, Ortiz, Peace, Perata,
Polanco, Poochigian, Rainey, Schiff, Sher, Solis, Speier,
Vasconcellos, Wright
ASSEMBLY FLOOR : 72-4, 9/8/99 - See last page for vote
SUBJECT : Primary health care services: rural areas
SOURCE : California Primary Care Association
DIGEST : This bill requires the Department of Health
CONTINUED
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Services (DHS) to grant funds for up to three years to
eligible, private, nonprofit, community-based primary care
clinics for the implementation of (1) local health programs
for seasonal agricultural and migratory workers and (2)
health services development projects in underserved rural
areas.
Assembly Amendments appropriate $1,653,000 from the
Physician Services Account in the Cigarette and Tobacco
Products Surtax Fund (Proposition 99 funds) to DHS for
expanded access to primary care clinics. Add a co-author
and an urgency clause.
ANALYSIS : Existing law requires DHS to contract and
cooperate with local government agencies and voluntary
nonprofit organizations in connection with the development
of local health programs for seasonal agricultural and
migratory workers.
Existing law also requires DHS to provide grants or loans
for the operation of health services development projects
in underserved rural areas.
This bill:
1.Revises existing law regarding health program grants for
seasonal agricultural and migratory workers (SAMW) and
for underserved rural health areas, and authorizes DHS to
grant funds for such projects for up to three years to
eligible, private, non-profit community-based primary
care clinics.
2.Requires DHS, to the extent that funds are available, to
provide to a grantee semiannual prospective payments
during a 12-month fiscal year. Specifically requires DHS
to provide:
(a)50% of the total grant, as specified, following
enactment of the annual Budget Act and upon formal
execution of the grant by the state provided certain
grant reporting requirements are met.
(b)40% of the total grant, as specified, no earlier than
January 1 during the term of the grant year,
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contingent upon the grantee's satisfactory
performance and provided certain grant reporting
requirements are met.
(c)10% of the total grant, as specified, upon
satisfactory completion and submission of all
specified grant reports and DHS approval of these
reports.
3.Requires the provision #1 and #2 above to become
operative July 1, 2000.
4.Appropriates $1,653,000 from Proposition 99 funds to DHS,
in augmentation of Item 4260-111-0233 of the Budget Act
of 1999, for EAPC clinics.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee
analysis, $1.653 million from Proposition 99 funds for
primary care clinics and minor one-time costs to DHS to
establish a prospective payment system for grants to
primary care clinics.
SUPPORT : (Verified 5/28/99) (Unable to re-verify at time
of writing)
California Primary Care Association (source)
ARGUMENTS IN SUPPORT : According to the author, clinics
that receive SAMW grants are paid, in arrears, monthly.
Reporting and processing requirements routinely result in
delayed payments, causing cash flow hardships for these
clinics. This bill would streamline the payment of grant
moneys to both SAMW and rural health clinics, allowing
clinics to receive program funds in advance, while
maintaining reasonable reporting requirements as a
condition for clinics to receive funds. Additionally, this
bill includes a budgetary appropriation. According to the
author, Governor Davis reduced, by $10.1 million, the $18
million (General Fund) legislative augmentation for EAPC
clinics, leaving an increase of only $7.9 million. The $6
million in Proposition 99 for the program was sustained.
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In his "blue pencil" message reducing the EAPC funding in
the budget, the Governor stated that he would sign
deficiency legislation which would appropriate an
additional $1.653 million in Proposition 99 funds as
proposed in the Governor's May revision. This bill would
enact such an appropriation for EAPC.
The California Primary Care Association states the
prospective payment system in this bill would provide much
needed financial stability for grantees that have suffered
great financial hardship as a result of delays in receiving
these funds. Under the current fund distribution system,
clinics experience three to six month delays in receipt of
grants. These delays are detrimental to the clinics'
already tight cash flow. Additionally, clinics are
required to submit invoices to DHS on a monthly basis and
are paid retroactively. This system is administratively
cumbersome for both DHS and the clinics. The prospective
payment system would not only solve the administrative
delays and cash flow problems suffered by the clinics, but
it would be more efficient and provide clinics with
immediate and timely access to their fund awards.
ASSEMBLY FLOOR :
AYES: Aanestad, Ackerman, Aroner, Ashburn, Bates, Battin,
Baugh, Bock, Brewer, Briggs, Calderon, Cardenas, Cardoza,
Cedillo, Corbett, Correa, Cox, Cunneen, Davis, Dickerson,
Ducheny, Dutra, Firebaugh, Florez, Floyd, Frusetta,
Gallegos, Havice, Hertzberg, Honda, House, Jackson,
Keeley, Knox, Kuehl, Leach, Lempert, Leonard, Longville,
Machado, Maddox, Maldonado, Margett, Mazzoni, Migden,
Nakano, Olberg, Oller, Robert Pacheco, Rod Pacheco,
Papan, Pescetti, Reyes, Romero, Runner, Scott, Shelley,
Soto, Steinberg, Strickland, Strom-Martin, Thomson,
Torlakson, Vincent, Washington, Wayne, Wesson, Wiggins,
Wildman, Wright, Zettel, Villaraigosa
NOES: Baldwin, Granlund, Kaloogian, McClintock
NOT VOTING: Alquist, Campbell, Lowenthal, Thompson
CP:sl 9/9/99 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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